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first discovered plasma intestinal flora-dependent small molecule metabolic spectrum by metabonomics and found that the plasma levels of TMAO and its precursors, choline and betaine, can predict the risk of human cardiovascular disease, thus identifying a novel relationship between intestinal flora and metabolic health ( In this paper, we describe in detail how TMAO promotes the transformation of macrophages to foam cells, which lead to reverse cholesterol transport that inhibits bile acid and sterol metabolism, and at the same time enhances the hyperactivity of platelets, which leads to the formation of atherosclerotic plaques

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